The Efficacy Analysis Of Totalhip Arthroplasty On Low Back Pain With Hip-spine Syndrome

Objective: To analysis and assess the effect of low back pain andspinal function after total hip arthroplasty in patients with hip-spinesyndrome; clinically validate hip-spine syndrome as hypothesized.Method: From September2010to March2012,30adult patientswith hip joint diseases coexisting low back pain were included. Amongthem, there were11males and19females, age from30years to77years,The mean age of thepatients was56.5years.There were10patients withosteoarthritis of the hip,10patients withavascular necrosis of the femoralhead(ANFH) and another10patients withdevelopmental dysplasia of thehip (DDH).All of the patients had unilateral hip disease. They wereperformed total hip arthroplasty. Before operation, the Harris Hip Score,visual analogue scales (VAS) and Oswestry Disability Index (ODI)wereused to evaluate hip and spine symptoms in the patients. After operation,all of the patients were asked to do rehabilitation training in the yard andat home.3months and1year later, the patients were evaluated and the3methods of marking were used again. The patients in the study were notgiven any specific therapy for the back pain during this period. Then usethe SPSS19.0software statistical analysis of the data obtained. Paired ttests and Wilcoxon tests were used to identify changes inpain andfunction before and afterTHA.P <0.05was considered statisticallysignificant.Result: After3months，all of the thirty patients were evaluated, butonly twenty-five patients were evaluated in1year’follow up,2patientsdied and3lost follow-up. Both hip and spinal pain and function were significant improved. In3months’ follow up, Harris score improved from44.62±4.67to80.07±4.21（P＜0.05）.VAS of low back pain decreasedfrom5.27±1.32to3.67±1.07（P＜0.05）. VAS of hip pain decreased from7.18±1.32to2.89±1.17（P＜0.05）. Oswestry score decreased from37.69±6.81to24.22±3.89（P＜0.05）. These index were furtherimproved1year after the operation except that the VAS of low back painwas similar with the result of3months’ follow up.VAS of low back paindecreased from3.67±1.07to3.56±0.89（P=0.133）. Harris score improvedfrom80.07±4.21to87.09±2.95（P＜0.05）. VAS of hip pain decreasedfrom2.89±1.17to0.98±0.62（P＜0.05）. Oswestry score decreased from24.22±3.89to19.60±2.88（P＜0.05）.Conclusion: Spinal function and low back pain were improved aftertotal hip arthroplasty in patients with hip joint diseases at3months,which is maintained and enhanced in1year．And our research clinicallyvalidate hip-spine syndrome as hypothesized.Whether the other diseasesthat involved hip joint, just like hip synovitis, snapping hip, ankylosingspondylitis can cause hip-spine syndrome requires further basic andclinical research to be confirmed.